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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:03,851 --> 00:00:06,375 In college, I was the hungover premed 2 00:00:06,507 --> 00:00:08,267 who fell asleep at her study carrel. 3 00:00:08,399 --> 00:00:09,925 If you're just joining our podcast, 4 00:00:10,058 --> 00:00:11,849 my guests are doctors Teddy Altman 5 00:00:11,983 --> 00:00:14,407 and Winston Ndugu from Grey-Sloan Memorial, 6 00:00:14,539 --> 00:00:17,660 who pioneered the creation of a ventral aorta surgery. 7 00:00:17,791 --> 00:00:20,845 At what point did you think, "We just broke new ground"? 8 00:00:20,977 --> 00:00:22,769 Immediately . 9 00:00:22,903 --> 00:00:24,530 - Really? - Yeah. Once that staple held, I knew. 10 00:00:24,661 --> 00:00:26,222 Sometimes you just have a feeling. 11 00:00:26,355 --> 00:00:28,943 In med school, I was the famous surgeon's daughter. 12 00:00:29,076 --> 00:00:30,968 It wasn't like that for you? 13 00:00:31,101 --> 00:00:32,826 Honestly, there was so much going on that night, 14 00:00:32,959 --> 00:00:35,283 I didn't have time to process it all until later. 15 00:00:35,416 --> 00:00:37,705 Now I'm the famous surgeon. 16 00:00:37,838 --> 00:00:39,067 - So you had doubts? - Oh, yeah. 17 00:00:39,200 --> 00:00:40,759 I was never certain it would work, 18 00:00:40,891 --> 00:00:42,584 but our patient didn't have any other option. 19 00:00:42,716 --> 00:00:43,878 I knew that we had to try. 20 00:00:45,007 --> 00:00:48,294 In medicine, your identity is constantly changing. 21 00:00:48,891 --> 00:00:50,285 It's your job to keep up. 22 00:00:50,783 --> 00:00:53,206 Safe to say it worked out. What's next for you both? 23 00:00:53,339 --> 00:00:55,694 Well, we're still monitoring our patients' progress. 24 00:00:55,827 --> 00:00:57,652 - And? - So far so good. 25 00:00:57,785 --> 00:01:00,110 They sound really good, very competent. 26 00:01:00,242 --> 00:01:01,735 Yeah. I'd come to this hospital. 27 00:01:01,868 --> 00:01:03,063 Well, speaking of... 28 00:01:03,660 --> 00:01:05,518 I made an appointment for you. 29 00:01:06,581 --> 00:01:09,303 We talked about this, Catherine. I don't need another opinion. 30 00:01:09,436 --> 00:01:10,829 I like Dr. Freeman. 31 00:01:10,963 --> 00:01:13,617 I know you do because he goes along with whatever you want. 32 00:01:13,749 --> 00:01:15,475 You don't think doctors should listen to their patients? 33 00:01:15,609 --> 00:01:17,933 I think you need objective advice 34 00:01:18,065 --> 00:01:20,057 from someone whose paycheck you don't sign. 35 00:01:21,285 --> 00:01:23,111 It's just another opinion. 36 00:01:24,802 --> 00:01:25,832 Who am I seeing? 37 00:01:26,395 --> 00:01:27,359 Kaplan. 38 00:01:27,490 --> 00:01:29,947 Laura Kaplan? In Boston? 39 00:01:30,081 --> 00:01:31,772 I thought you made an appointment here. 40 00:01:31,906 --> 00:01:33,234 I sent for my plane. 41 00:01:33,365 --> 00:01:35,059 She landed about an hour ago. 42 00:01:40,402 --> 00:01:41,463 Morning. 43 00:01:41,596 --> 00:01:42,859 -Hey. -Hey. 44 00:01:42,991 --> 00:01:44,751 Hey, nice job on that podcast. 45 00:01:44,883 --> 00:01:47,273 I didn't realize you and Altman came up with that at our wedding. 46 00:01:47,405 --> 00:01:49,629 Yeah, you never know when an idea will strike. 47 00:01:49,762 --> 00:01:51,986 - Mmm. - Go ahead, Dr. Adams. 48 00:01:52,118 --> 00:01:53,779 Uh, yes. Uh, Jo Wilson. 49 00:01:53,911 --> 00:01:58,159 Post-op day seven from emergency C-section and Impella CP placement. 50 00:01:58,291 --> 00:02:00,814 Now post-op day three from a 5.5 placement 51 00:02:00,948 --> 00:02:02,340 through the right axillary artery. 52 00:02:02,473 --> 00:02:04,764 Her heart function continues to recover 53 00:02:04,897 --> 00:02:06,589 with her EF up another five percent, 54 00:02:06,723 --> 00:02:09,310 and I heard she got to meet her babies yesterday. 55 00:02:09,443 --> 00:02:11,202 -How are they doing? -Hmm. 56 00:02:11,334 --> 00:02:13,592 Peyton's off of CPAP but still fragile. 57 00:02:13,726 --> 00:02:15,551 Hattie's bilirubin levels are bad 58 00:02:15,684 --> 00:02:18,041 every time they pause phototherapy. 59 00:02:18,172 --> 00:02:20,032 And you're all headed in the right direction. 60 00:02:20,163 --> 00:02:21,127 That's what matters. 61 00:02:21,259 --> 00:02:22,287 I just... 62 00:02:23,052 --> 00:02:25,972 really want the six of us to finally be together. 63 00:02:26,570 --> 00:02:27,998 Jo, you will never guess 64 00:02:28,162 --> 00:02:29,789 - who Marcus walked out with last night. - -Who? 65 00:02:29,923 --> 00:02:31,315 - Dr. Ndugu. - Hey. 66 00:02:31,448 --> 00:02:33,739 -I didn't know you were doing rounds. -Yeah. 67 00:02:34,735 --> 00:02:36,128 I'll come back later. 68 00:02:39,846 --> 00:02:41,272 What was that? 69 00:02:41,405 --> 00:02:44,426 -What was what? -Did you sleep with my favorite nurse? 70 00:02:44,560 --> 00:02:46,020 -Jo... -Uh, should I leave? 71 00:02:46,151 --> 00:02:47,679 We've just gone out a couple times. That's all. 72 00:02:47,811 --> 00:02:49,671 Well, are you gonna take her out again? 73 00:02:49,803 --> 00:02:52,026 Uh, just... Maybe. It's new and-- 74 00:02:52,158 --> 00:02:53,621 And none of our business. 75 00:02:53,753 --> 00:02:57,437 She is the entire department's favorite nurse. 76 00:02:57,968 --> 00:03:00,358 Everybody loves her. Everyone. 77 00:03:05,102 --> 00:03:06,664 - Hormones. - Okay. 78 00:03:06,796 --> 00:03:09,518 Uh, I-I need to check on my next patient. Are you gonna be okay? 79 00:03:09,651 --> 00:03:12,406 -Yeah. -Uh, page me if you need anything. 80 00:03:16,388 --> 00:03:17,418 Good morning. 81 00:03:17,550 --> 00:03:18,613 Traitor. 82 00:03:18,745 --> 00:03:20,770 -Trouble in paradise? -I broke our pact. 83 00:03:20,902 --> 00:03:22,762 -She's bitter. -Then you should break it too. 84 00:03:23,326 --> 00:03:24,553 What, I can just snap my fingers? 85 00:03:24,686 --> 00:03:25,880 Who am I supposed to sleep with? 86 00:03:26,012 --> 00:03:28,999 I ordered an X-ray for Ms. Johnson's left arm. 87 00:03:29,499 --> 00:03:31,158 It was the right arm, wasn't it? 88 00:03:31,656 --> 00:03:33,016 I will fix it. 89 00:03:34,445 --> 00:03:36,103 An intern? Please. I have dignity. 90 00:03:36,236 --> 00:03:38,294 -Don't knock it until you've tried it. -Tried what? 91 00:03:38,857 --> 00:03:39,986 Vegan sloppy joes. 92 00:03:40,119 --> 00:03:41,447 You sleeping with an intern too? 93 00:03:41,580 --> 00:03:43,505 Wait. Who's sleeping with an intern? 94 00:03:43,638 --> 00:03:45,298 I am. Who are you texting? 95 00:03:45,430 --> 00:03:46,724 Nobody. 96 00:03:46,857 --> 00:03:48,650 -Doesn't look like nobody. -Nah, she's just a patient. 97 00:03:48,781 --> 00:03:50,342 Why are you texting a patient? 98 00:03:50,475 --> 00:03:52,433 Yeah, well, Bailey made me drive her an hour to get treatment, 99 00:03:52,566 --> 00:03:53,926 and now she's sending me dumb memes. 100 00:03:54,059 --> 00:03:55,553 -It's nothing. -Wear a condom. 101 00:03:55,686 --> 00:03:57,113 She's a cancer patient. 102 00:03:57,578 --> 00:03:59,702 Hey. Did you see that I admitted Mr. Howard? 103 00:03:59,834 --> 00:04:01,394 You don't have to put your phone down. 104 00:04:01,528 --> 00:04:02,821 -It's fine. -Sorry. 105 00:04:02,954 --> 00:04:05,477 My phone has been blowing up since the podcast dropped. 106 00:04:05,610 --> 00:04:07,137 I listened. You sounded great. 107 00:04:07,269 --> 00:04:09,228 Well, now I've got doctors reaching out about their patients, 108 00:04:09,360 --> 00:04:10,687 and the department chief from Mass General 109 00:04:10,819 --> 00:04:12,016 has asked me to do grand rounds. 110 00:04:12,148 --> 00:04:13,310 Hmm. Sounds rough. 111 00:04:13,442 --> 00:04:15,368 Well, it's not like I'm getting a Nobel Prize. 112 00:04:15,500 --> 00:04:17,690 I mean, MGH asks everyone to guest lecture. 113 00:04:17,823 --> 00:04:19,317 They never asked me, and I went to Harvard. 114 00:04:19,450 --> 00:04:22,504 Anyway, so, Mr. Howard, his EKG shows a conduction block. 115 00:04:22,635 --> 00:04:26,918 -Do you want an echo? -Um, yes. Sorry, I have to take this. 116 00:04:27,051 --> 00:04:28,676 Hi, this is Altman. 117 00:04:28,809 --> 00:04:32,826 Hi, Janet, I'm, uh, Dr. Millin. I hear you're having some leg pain. 118 00:04:32,958 --> 00:04:34,319 Yeah, and some heaviness. 119 00:04:34,453 --> 00:04:35,712 I'm concerned it might be a DVT. 120 00:04:35,846 --> 00:04:37,107 I think she should have an ultrasound. 121 00:04:37,240 --> 00:04:38,666 I assume you want a full work up. 122 00:04:38,800 --> 00:04:41,753 CBC, D-dimer, and a duplex ultrasound? 123 00:04:42,716 --> 00:04:43,978 I'm Jules Millin. 124 00:04:44,110 --> 00:04:46,632 I'm a second-year surgical resident. 125 00:04:46,766 --> 00:04:47,861 You're internal medicine, right? 126 00:04:48,790 --> 00:04:51,213 Oh, no. Oh. I'm not a doctor. Sorry. Yeah. 127 00:04:51,346 --> 00:04:52,905 -Oh, we were role-playing. -Yeah. 128 00:04:53,039 --> 00:04:54,797 The more medical terms, the better it gets. 129 00:04:54,931 --> 00:04:57,387 -Yeah. -So, Hal does his homework. 130 00:04:58,580 --> 00:05:01,037 -So do you have leg pain or is this-- -Oh, no, that's real. 131 00:05:01,170 --> 00:05:02,763 The pain started this morning when we were trying 132 00:05:02,896 --> 00:05:04,257 to squeeze in a quickie before work. 133 00:05:05,451 --> 00:05:07,210 - May I do an exam? - Mm-hmm. 134 00:05:09,434 --> 00:05:12,454 Um, how long did the pain last for? 135 00:05:12,587 --> 00:05:14,544 -Uh, a few hours? -Yeah. 136 00:05:14,679 --> 00:05:16,272 We've been trying to spice things up lately, 137 00:05:16,404 --> 00:05:19,226 so we just wanna make sure we haven't, uh, caused a problem. 138 00:05:19,856 --> 00:05:21,482 Oh, um... 139 00:05:21,616 --> 00:05:26,860 DVTs usually occur with less, um, activity, 140 00:05:26,992 --> 00:05:30,908 but it is better to be safe than sorry, so I will order some tests. 141 00:05:31,042 --> 00:05:32,966 - All right. - And get back to you. 142 00:05:33,099 --> 00:05:34,493 -Okay. Thank you. -Thank you. 143 00:05:36,186 --> 00:05:37,313 Dr. Griffith. 144 00:05:37,813 --> 00:05:41,463 A 38-year-old female with a large mediastinal teratoma 145 00:05:41,596 --> 00:05:44,085 - that has been resistant to chemotherapy. 146 00:05:44,218 --> 00:05:45,943 Presents with progressive shortness of breath, 147 00:05:46,077 --> 00:05:47,239 orthopnea, and angina. 148 00:05:47,403 --> 00:05:48,931 It has to be at least 35 pounds. 149 00:05:49,064 --> 00:05:52,084 And, uh, 27 centimeters for the longest diameter. 150 00:05:52,217 --> 00:05:55,602 The tumor is displacing the heart and great vessels. 151 00:05:55,735 --> 00:05:57,892 The SVC is compressed, 152 00:05:58,025 --> 00:06:01,045 and it's also indenting the right lobe of the liver. 153 00:06:01,178 --> 00:06:02,539 Hmm. How are the lungs? 154 00:06:02,672 --> 00:06:04,032 Compressed with near total collapse 155 00:06:04,166 --> 00:06:05,260 of the mid-right and lower lobes. 156 00:06:05,393 --> 00:06:07,185 Has anyone tried to operate on the thing? 157 00:06:07,318 --> 00:06:09,542 Her name is London 158 00:06:09,675 --> 00:06:12,330 and, yes, there have been two attempts at Seattle Pres. 159 00:06:12,463 --> 00:06:16,445 They had to abort both times because she arrested on the table. 160 00:06:16,579 --> 00:06:18,769 But you believe you would have a different outcome if you tried? 161 00:06:18,901 --> 00:06:22,586 Well, I have removed extremely difficult tumors before, 162 00:06:22,719 --> 00:06:24,876 and this one is benign. 163 00:06:25,009 --> 00:06:29,622 So, if we can successfully remove it, then she resumes a normal life. 164 00:06:29,755 --> 00:06:31,680 Even if you convinced anesthesia, 165 00:06:31,813 --> 00:06:34,435 you could still encounter catastrophic bleeding. 166 00:06:34,568 --> 00:06:36,957 And that is why I'm here at the tumor board, 167 00:06:37,089 --> 00:06:41,239 where people help their colleagues to come up with a plan. 168 00:06:41,372 --> 00:06:46,184 If anyone here thinks this remotely is a possibility, please speak up. 169 00:06:46,317 --> 00:06:47,478 Yes. 170 00:06:53,187 --> 00:06:55,146 It's a tragic case, Dr. Bailey, but... 171 00:06:56,340 --> 00:06:58,664 - It's a lawsuit waiting to happen. 172 00:07:01,452 --> 00:07:02,481 I'll do it with you. 173 00:07:06,829 --> 00:07:09,284 - The alternative is hospice, right? 174 00:07:09,418 --> 00:07:10,943 Dr. Hunt, it just can't be done. 175 00:07:11,077 --> 00:07:13,466 Yeah, well, you don't know what we're capable of. 176 00:07:18,578 --> 00:07:20,602 -Bye. -I knew you'd have an idea. 177 00:07:20,736 --> 00:07:22,129 Yeah, I got nothing. 178 00:07:24,652 --> 00:07:25,680 What? 179 00:07:37,430 --> 00:07:39,089 Well, look who's here. 180 00:07:39,620 --> 00:07:41,048 How was your flight? 181 00:07:41,180 --> 00:07:43,504 - Most quiet I've had in months. - Oh, great. 182 00:07:43,637 --> 00:07:45,594 -Dr. Webber, it's a pleasure. -Hi. 183 00:07:46,391 --> 00:07:47,652 I've heard a lot about you. 184 00:07:47,785 --> 00:07:49,013 All good things. 185 00:07:49,146 --> 00:07:51,569 Catherine's thrilled you joined the team in Boston. 186 00:07:51,702 --> 00:07:53,892 She's thrilled she poached me from Sloan Kettering. 187 00:07:54,025 --> 00:07:58,373 You are at the forefront of urologic oncology, and that lecture that you gave 188 00:07:58,506 --> 00:08:00,828 to the American Urological Association last month 189 00:08:00,962 --> 00:08:02,555 brought the house down. 190 00:08:02,687 --> 00:08:07,998 And she is developing a program that uses AI to study biomarkers. 191 00:08:08,131 --> 00:08:09,591 We just received another grant for it yesterday. 192 00:08:09,724 --> 00:08:10,985 You bet you did. 193 00:08:11,118 --> 00:08:14,038 Now, tell us about my husband's prostate. 194 00:08:14,172 --> 00:08:15,366 Catherine, please. 195 00:08:16,727 --> 00:08:19,017 -If now's not a good time-- -Don't be ridiculous. 196 00:08:19,150 --> 00:08:20,643 Come on, everybody. Sit down. 197 00:08:20,776 --> 00:08:22,635 Have a seat. Come on. 198 00:08:24,195 --> 00:08:25,822 Good news is you caught it early. 199 00:08:25,954 --> 00:08:27,514 Grade group two, a seven Gleason. 200 00:08:27,647 --> 00:08:31,099 Well, he knows all of that. So tell us, what do you suggest? 201 00:08:31,695 --> 00:08:32,891 Well, given the cancer's localized, 202 00:08:33,023 --> 00:08:34,650 and you're generally in good health, 203 00:08:34,783 --> 00:08:36,542 I recommend a radical prostatectomy. 204 00:08:37,172 --> 00:08:38,600 I couldn't agree more. 205 00:08:39,363 --> 00:08:40,989 If you're worried about side effects, 206 00:08:41,122 --> 00:08:44,740 urinary incontinence, erectile dysfunction, they are a risk. 207 00:08:44,872 --> 00:08:47,162 -But for many men-- -What about infection? 208 00:08:47,627 --> 00:08:49,851 It's unlikely but possible. 209 00:08:49,984 --> 00:08:54,929 Blood clots, stroke, injury to the rectum, bladder, nerves? 210 00:08:55,062 --> 00:08:56,555 They're all possible too, right? 211 00:08:59,741 --> 00:09:00,771 Yeah. 212 00:09:02,197 --> 00:09:03,525 Thank you for your time, 213 00:09:03,658 --> 00:09:06,545 but I've already selected an option with my own doctor. 214 00:09:07,242 --> 00:09:08,238 Watchful waiting. 215 00:09:08,372 --> 00:09:10,031 I've got patients to see. 216 00:09:16,569 --> 00:09:18,229 Not seeing abnormalities. 217 00:09:18,361 --> 00:09:19,556 What's that wand called? 218 00:09:19,689 --> 00:09:20,817 An ultrasound probe. 219 00:09:20,951 --> 00:09:22,012 -Write that down. -Okay. 220 00:09:23,506 --> 00:09:25,830 Right, the ultrasound is negative. 221 00:09:26,360 --> 00:09:27,787 So, she doesn't have a clot? 222 00:09:27,920 --> 00:09:29,148 Not that I can see. 223 00:09:29,282 --> 00:09:31,007 Sounds like maybe there still might be one... 224 00:09:31,139 --> 00:09:33,165 Well, your D-dimer was slightly elevated, 225 00:09:33,297 --> 00:09:34,658 which is the marker we look at for clots. 226 00:09:34,791 --> 00:09:37,147 It doesn't necessarily mean anything, but it is reason 227 00:09:37,280 --> 00:09:38,574 to come back if you have any more pain. 228 00:09:38,707 --> 00:09:41,794 Maybe I just need to stretch before I go to the doctor. 229 00:09:41,926 --> 00:09:43,122 - Mmm. - Stretch? 230 00:09:43,254 --> 00:09:44,349 Uh, don't ask any questions. 231 00:09:44,482 --> 00:09:46,474 I'm gonna start your, um, discharge paperwork. 232 00:09:47,336 --> 00:09:48,531 What was that all about? 233 00:09:48,664 --> 00:09:50,457 They like to role-play doctor and patient in bed. 234 00:09:50,589 --> 00:09:52,049 Good for them. 235 00:09:53,842 --> 00:09:55,999 They're so cute. 236 00:09:56,829 --> 00:09:58,124 Rustic cute? 237 00:09:58,256 --> 00:10:00,149 Five reviews say those rockers broke within a year. 238 00:10:01,343 --> 00:10:02,935 How's the lake house? 239 00:10:03,070 --> 00:10:06,454 We've moved from arguing over tile to arguing over porch chairs. 240 00:10:07,649 --> 00:10:09,044 How was the tumor board? 241 00:10:09,175 --> 00:10:12,993 Uh, unfortunately, they are concerned about the risks 242 00:10:13,158 --> 00:10:15,747 and recommend that we don't proceed. 243 00:10:15,880 --> 00:10:21,223 So naturally I called in reinforcements. This is Dr. Owen Hunt. 244 00:10:21,356 --> 00:10:23,845 -He's one of our trauma surgeons. -Hi. 245 00:10:23,979 --> 00:10:26,069 If it's okay with you, I'd like to work with Dr. Bailey 246 00:10:26,202 --> 00:10:28,791 to make sure that we've explored every possible option. 247 00:10:28,925 --> 00:10:30,318 I want to help. 248 00:10:30,450 --> 00:10:32,176 - I like him. - Mmm. 249 00:10:33,007 --> 00:10:35,860 If everyone else has reservations, why do you think you can do it? 250 00:10:36,458 --> 00:10:42,333 Charlie, we've actually found surgeons that are not giving us a hard no. 251 00:10:42,465 --> 00:10:44,523 And I've almost lost you twice. 252 00:10:44,656 --> 00:10:48,107 I'm definitely not ready to lose you today from some botched operation. 253 00:10:48,241 --> 00:10:51,593 -Neither are we. -Hey, I'm still here. 254 00:10:52,290 --> 00:10:54,613 They're just asking if they can go work on a plan. 255 00:10:55,210 --> 00:10:58,629 If their plan leads to us growing old together, 256 00:10:58,762 --> 00:11:04,304 looking at the water from shoddy but very cute rocking chairs... 257 00:11:05,898 --> 00:11:08,520 I'm in. Aren't you? 258 00:11:12,702 --> 00:11:14,694 You really think you can figure out a way to keep 259 00:11:14,827 --> 00:11:16,485 her heart from stopping when she's on that table? 260 00:11:16,618 --> 00:11:19,505 Look, if we can't figure this out, we won't proceed, right? 261 00:11:19,639 --> 00:11:21,961 That was our deal when you two came to me. 262 00:11:23,588 --> 00:11:25,414 Okay, work on your plan. 263 00:11:25,546 --> 00:11:27,339 -Okay. -We'll be back. 264 00:11:27,471 --> 00:11:28,799 Okay. 265 00:11:35,536 --> 00:11:38,756 Hi, my cuties. 266 00:11:40,716 --> 00:11:42,707 They look bigger. Did they get bigger? 267 00:11:42,838 --> 00:11:45,726 Hattie's put on a full ounce in the last 24 hours, 268 00:11:45,858 --> 00:11:47,983 -and Peyton isn't far behind. -That's right. 269 00:11:48,115 --> 00:11:49,677 Lincolns know how to bulk. 270 00:11:52,929 --> 00:11:54,622 I gotta go to PT. Sure you're okay? 271 00:11:54,754 --> 00:11:56,181 -Yeah. -Okay. You sure? 272 00:11:56,314 --> 00:11:57,442 Yeah. 273 00:11:58,703 --> 00:12:00,496 -All right. -Okay. 274 00:12:01,923 --> 00:12:03,350 -See you soon. -Yeah. 275 00:12:05,906 --> 00:12:07,533 You're Peyton and Hattie's mom? 276 00:12:08,262 --> 00:12:10,387 Mm-hmm. 277 00:12:12,178 --> 00:12:14,170 Sorry, it's just that, um... 278 00:12:14,900 --> 00:12:18,219 That's the first time that somebody's called me their mom. 279 00:12:19,415 --> 00:12:20,444 Here. 280 00:12:22,169 --> 00:12:24,625 Oh, wait, that one's not clean. 281 00:12:26,019 --> 00:12:27,014 -Here. -Thanks. 282 00:12:27,645 --> 00:12:31,031 I'm an OB-GYN, and I talk to my patients 283 00:12:31,163 --> 00:12:33,719 all the time about postpartum hormone drops, 284 00:12:33,852 --> 00:12:37,768 but I had no idea it was this intense and just random. 285 00:12:38,267 --> 00:12:42,283 Yesterday, my boyfriend and I were buying diapers for me not the baby, 286 00:12:42,416 --> 00:12:46,929 and the guy ringing me up said, "Will that be all?" And I burst into tears. 287 00:12:47,062 --> 00:12:49,086 It's nice to know that I'm not alone. 288 00:12:51,542 --> 00:12:53,136 What? 289 00:12:53,269 --> 00:12:55,093 You're my first mom friend. 290 00:12:55,691 --> 00:12:58,215 Oh. I'm honored. 291 00:12:58,347 --> 00:13:00,935 Did you tear or... Can I ask you that? 292 00:13:01,067 --> 00:13:04,355 Yeah, you can ask me anything, but, um, no, I-I didn't tear. 293 00:13:04,486 --> 00:13:08,271 I, uh... ...I had something called a crash C-section. 294 00:13:08,402 --> 00:13:10,428 Oh, tell me everything. 295 00:13:12,916 --> 00:13:13,946 I'll be back. 296 00:13:14,079 --> 00:13:16,170 Richard, what the hell are you doing? 297 00:13:16,834 --> 00:13:18,692 I'm about to check Mr. Tolli's wound VAC. 298 00:13:18,825 --> 00:13:21,248 You said you would hear Kaplan out. 299 00:13:21,380 --> 00:13:23,073 I did. 300 00:13:23,207 --> 00:13:25,165 Is this because you're worried about the bedroom? 301 00:13:25,297 --> 00:13:27,986 Because you know we'll figure that out. 302 00:13:30,342 --> 00:13:31,403 Come on. 303 00:13:37,245 --> 00:13:38,539 I'm not having this conversation here. 304 00:13:38,673 --> 00:13:40,963 Is this because you prefer a male doctor? 305 00:13:41,097 --> 00:13:42,356 Now that's insulting! 306 00:13:42,489 --> 00:13:44,017 Well, I'm just trying to understand why 307 00:13:44,149 --> 00:13:47,401 you would dismiss a top urologist like she's an intern. 308 00:13:47,534 --> 00:13:49,426 I moved mountains to bring her here for you. 309 00:13:49,559 --> 00:13:50,720 I didn't ask you to. 310 00:13:51,949 --> 00:13:53,841 Now, my cancer hasn't metastasized. 311 00:13:53,974 --> 00:13:56,462 Watchful waiting is a perfectly reasonable option. 312 00:13:57,094 --> 00:14:00,115 I respected your health care decisions even when I didn't agree. 313 00:14:00,910 --> 00:14:02,636 I need you to do the same for me. 314 00:14:04,561 --> 00:14:07,084 ...1962. 315 00:14:07,216 --> 00:14:09,706 -Who was the surgeon at Seattle Pres? -Collins. 316 00:14:09,839 --> 00:14:13,423 Yeah, he actually did his residency here a couple of years behind me. 317 00:14:13,555 --> 00:14:17,008 When his chief wouldn't let him try again, he sent London to me. 318 00:14:17,140 --> 00:14:19,231 If she codes the minute she lays on the table, 319 00:14:19,363 --> 00:14:21,056 why didn't they try a reverse Trendelenburg? 320 00:14:21,188 --> 00:14:23,645 Keep her at an incline to take the pressure off some of the cardiac vessels? 321 00:14:23,779 --> 00:14:26,400 Oh, no, they did. Uh, but see how compressed they are? 322 00:14:26,533 --> 00:14:28,059 It wasn't enough. 323 00:14:28,192 --> 00:14:29,886 Okay, what about conscious sedation instead of general anesthesia? 324 00:14:30,018 --> 00:14:32,507 She'd continue to breathe on her own, which would help 325 00:14:32,641 --> 00:14:35,361 blood return back to the heart and minimize airway collapse. 326 00:14:35,494 --> 00:14:37,785 I mean, it might help some... 327 00:14:37,918 --> 00:14:39,777 The tumor's matured into its own ecosystem. 328 00:14:39,909 --> 00:14:41,335 You can see the calcifications, 329 00:14:41,469 --> 00:14:45,385 -fat, the cystic components. -Yeah? What? 330 00:14:45,517 --> 00:14:47,809 What if we drain it? Shrink the mass before we go in? 331 00:14:47,940 --> 00:14:49,998 It's a good idea, but the location is just too risky. 332 00:14:50,131 --> 00:14:52,388 We can't risk the contents of the tumor spilling into the chest. 333 00:14:52,521 --> 00:14:54,213 It would just regrow. 334 00:14:54,346 --> 00:14:55,609 I gotta run to a consult in the pit, 335 00:14:55,741 --> 00:14:56,902 but I will keep thinking on this. 336 00:14:57,034 --> 00:14:59,092 No promises though. 337 00:15:00,154 --> 00:15:04,403 Adams, Griffith, let's look up every case report published on mediastinal teratomas. 338 00:15:04,536 --> 00:15:07,224 Research patterns, cross-reference solutions, okay? 339 00:15:08,319 --> 00:15:09,879 We all just listened to a podcast this morning 340 00:15:10,012 --> 00:15:11,605 about how our hospital pulled off a miracle. 341 00:15:11,739 --> 00:15:14,061 Who's to say we can't do it again, right? Go. 342 00:15:17,049 --> 00:15:19,306 We're gonna come up with something. 343 00:15:20,965 --> 00:15:22,426 -Hey. -Hi. 344 00:15:22,558 --> 00:15:24,980 -Are you done with that tablet? -Nope, get your own. 345 00:15:25,114 --> 00:15:28,067 Bailey and Hunt have a massive mediastinal teratoma. 346 00:15:28,533 --> 00:15:30,591 If you sweet-talk Bailey, you can get in on it with us. 347 00:15:30,724 --> 00:15:31,720 They're looking for ideas. 348 00:15:31,851 --> 00:15:33,346 I'm too swamped down here. 349 00:15:34,308 --> 00:15:36,730 Hey, I'm sorry about this morning. 350 00:15:36,862 --> 00:15:38,854 - Jo's crying about everything these days. - It's fine. 351 00:15:38,987 --> 00:15:43,502 But she loves Iris, so she'll be happy if you two are a thing. 352 00:15:50,571 --> 00:15:52,563 -Why are you acting weird? -I'm not acting weird. 353 00:15:52,694 --> 00:15:54,554 Yeah, you are. 354 00:15:54,685 --> 00:15:56,910 -Help. Help my wife! Help. -Hal? 355 00:15:57,042 --> 00:15:58,735 - Sir, you might wanna button that. - Oh, my God. Janet. 356 00:16:03,516 --> 00:16:04,776 I'm getting weak pulses. 357 00:16:05,341 --> 00:16:07,597 Janet, look at me. I'm going to care of you, okay? 358 00:16:08,061 --> 00:16:09,588 We need a gurney in here! 359 00:16:16,493 --> 00:16:18,484 The plane won't be ready for another couple of hours. 360 00:16:18,649 --> 00:16:21,570 -Catherine said I could work in here. -Not a problem. 361 00:16:24,889 --> 00:16:26,284 I owe you an apology. 362 00:16:27,180 --> 00:16:29,967 I was led to believe that you were the one seeking a second opinion. 363 00:16:30,101 --> 00:16:31,329 You couldn't have known. 364 00:16:31,926 --> 00:16:33,485 I should have at least suspected. 365 00:16:34,084 --> 00:16:35,676 I think your wife broke contract laws 366 00:16:35,809 --> 00:16:37,236 to ensure my employment at her hospital. 367 00:16:37,370 --> 00:16:38,530 Don't feel bad. 368 00:16:38,663 --> 00:16:41,749 You're not the first to fall prey to her ways. 369 00:16:42,281 --> 00:16:44,471 - I'm guessing I won't be the last. 370 00:16:44,604 --> 00:16:46,298 She does it 'cause she cares. 371 00:16:47,294 --> 00:16:48,953 That's what makes it infuriating. 372 00:16:53,565 --> 00:16:54,594 Feel free to say no. 373 00:16:55,656 --> 00:16:58,510 But I've got a patient with a retroperitoneal tumor, 374 00:16:58,643 --> 00:17:03,356 and I would be remiss if I didn't ask Fox Hospitals' Chief of Chiefs for a consult. 375 00:17:04,817 --> 00:17:07,307 -No. Got a little time. -Yeah. 376 00:17:07,439 --> 00:17:11,256 How about we get a couple of pastries to go with this coffee? 377 00:17:11,720 --> 00:17:13,745 - Thank you. That would be great. 378 00:17:14,974 --> 00:17:16,866 "Twenty-two-pound teratoma in the abdomen. 379 00:17:17,562 --> 00:17:21,779 San Francisco, 2018." They started with a CT-guided drainage. 380 00:17:21,911 --> 00:17:23,403 Yeah, but look at the picture of the CT. 381 00:17:23,536 --> 00:17:24,865 Nowhere near the heart. 382 00:17:24,997 --> 00:17:26,922 Another dead end. 383 00:17:28,647 --> 00:17:30,043 Another dumb meme from your patient? 384 00:17:30,175 --> 00:17:31,668 No, she's asking for movie recs. 385 00:17:32,331 --> 00:17:33,427 She's stuck at home. 386 00:17:34,092 --> 00:17:36,547 Not exactly a doctor-patient conversation topic. 387 00:17:37,310 --> 00:17:39,866 She's Bailey's patient. She has stage four gastric cancer. 388 00:17:40,000 --> 00:17:41,991 She can ask whatever she wants. 389 00:17:42,123 --> 00:17:43,483 I mean, shouldn't you keep it professional? 390 00:17:43,617 --> 00:17:45,442 Look, you have no idea what you're talking about. It's-- 391 00:17:45,574 --> 00:17:47,334 I'm just saying, you're young, you're single. You... 392 00:17:48,163 --> 00:17:50,553 You look like you might be leading her on. 393 00:17:51,948 --> 00:17:53,110 I'm her doctor. 394 00:17:53,241 --> 00:17:54,769 And she's a vulnerable patient. 395 00:17:55,566 --> 00:17:57,257 I don't... I don't need this right now. 396 00:17:57,390 --> 00:17:59,648 -I'm just trying to look out for you. -Yeah, try less. 397 00:18:02,170 --> 00:18:03,830 Hunt's asking for an update. 398 00:18:06,418 --> 00:18:09,140 - Okay, anything? - Not yet. Thanks. 399 00:18:12,824 --> 00:18:16,341 Why did you join this case when everyone else dismissed it? 400 00:18:16,476 --> 00:18:17,638 It's like you said, it's benign. 401 00:18:17,770 --> 00:18:19,562 Once it's out, she moves on with her life. 402 00:18:19,695 --> 00:18:22,350 There's no worry of mets or recurrence. 403 00:18:25,369 --> 00:18:28,856 Yeah... ...I might be feeling a little uninspired lately. 404 00:18:28,987 --> 00:18:32,606 Uh-huh. Wouldn't have to do with other people solving 405 00:18:32,738 --> 00:18:34,961 cases at weddings and doing podcasts, would it? 406 00:18:37,119 --> 00:18:38,481 I see you at drop-off. 407 00:18:38,613 --> 00:18:40,738 I know everything's falling on you right now. 408 00:18:40,870 --> 00:18:44,188 She's lecturing and you're packing lunches. 409 00:18:44,322 --> 00:18:47,343 I'm happy to do it, and she deserves all the attention. 410 00:18:47,972 --> 00:18:50,130 I just think this tumor was... 411 00:18:51,823 --> 00:18:53,183 I don't know. 412 00:18:53,317 --> 00:18:56,536 My patient cannot be the fix to get you out of this slump. 413 00:18:57,499 --> 00:18:58,827 What have you got? 414 00:18:58,958 --> 00:19:01,481 Ten cases, at least half of them considered inoperable. 415 00:19:01,614 --> 00:19:03,837 And none of the masses are nearly the same size. 416 00:19:03,969 --> 00:19:06,061 There's one case that reported a similar arrest in the OR, 417 00:19:06,194 --> 00:19:07,853 but the team never tried it again 418 00:19:07,986 --> 00:19:10,044 because they couldn't safely find a way around the heart and lungs. 419 00:19:10,609 --> 00:19:13,097 Which is exactly what happened with London. 420 00:19:13,231 --> 00:19:15,754 As difficult as this is for me to say... 421 00:19:17,047 --> 00:19:19,071 I think we're out of options. 422 00:19:19,205 --> 00:19:20,467 What about ECMO? 423 00:19:20,599 --> 00:19:22,225 What about it? 424 00:19:22,359 --> 00:19:25,146 We need to bypass the pulmonary system, so why don't we use ECMO? 425 00:19:25,279 --> 00:19:26,937 The machine oxygenates and pumps the blood 426 00:19:27,071 --> 00:19:28,730 so her heart and lungs don't have to. 427 00:19:28,862 --> 00:19:33,377 There is no arrest if the machine is acting as her heart. 428 00:19:35,037 --> 00:19:37,924 Don't say no yet. I'm gonna go find Ndugu. 429 00:19:38,489 --> 00:19:39,517 Okay. 430 00:19:41,509 --> 00:19:42,868 Almost there, Janet. 431 00:19:43,003 --> 00:19:45,126 If this is a clot, you can fix it, right? 432 00:19:46,587 --> 00:19:48,843 Blood clots are treatable if you catch them in time, 433 00:19:48,977 --> 00:19:50,238 so it's a good thing you're here. 434 00:19:52,163 --> 00:19:53,424 Weird but good. 435 00:19:53,557 --> 00:19:56,444 I should probably be embarrassed, but I'm proud of us. 436 00:19:56,578 --> 00:19:58,733 All my friends got bored of their spouses 437 00:19:58,866 --> 00:20:02,386 and filed for divorce, but we got creative. 438 00:20:02,518 --> 00:20:04,707 By coming to the hospital and having sex. 439 00:20:05,904 --> 00:20:08,591 Don't be jealous. I'm sure other people aren't getting any either. 440 00:20:08,724 --> 00:20:10,518 All right, let me see. 441 00:20:13,339 --> 00:20:16,127 Looks like there's a left iliac vein thrombosis. 442 00:20:16,259 --> 00:20:17,819 Hal was right. DVT. 443 00:20:17,952 --> 00:20:21,205 If you look closely, the iliac artery is compressing the vein. 444 00:20:21,337 --> 00:20:23,196 -May-Thurner syndrome. -Mm-hmm. 445 00:20:23,328 --> 00:20:24,922 All right, let's book an angio suite 446 00:20:25,054 --> 00:20:28,472 for a thrombectomy and iliac vein stenting and start practicing. 447 00:20:28,604 --> 00:20:30,963 I'm gonna supervise you doing the procedure. 448 00:20:32,522 --> 00:20:34,082 -Me? -She means me. 449 00:20:34,879 --> 00:20:38,231 I don't care who it is as long as you guys are prepped and ready to go. 450 00:20:42,214 --> 00:20:43,540 You really think this will work? 451 00:20:43,674 --> 00:20:46,694 The challenge, right, has always been the pressure 452 00:20:46,827 --> 00:20:49,084 that your tumor is putting on your heart, 453 00:20:49,217 --> 00:20:52,668 your lungs and major arteries when you're positioned for surgery. 454 00:20:52,802 --> 00:20:54,360 And the ECMO machine makes that irrelevant 455 00:20:54,493 --> 00:20:56,518 because it oxygenates and pumps your blood for you. 456 00:20:56,651 --> 00:20:59,406 So no matter what happens, your body will receive oxygen 457 00:20:59,538 --> 00:21:01,132 and blood flow while we work. 458 00:21:01,929 --> 00:21:04,020 I can't believe you actually figured it out. 459 00:21:04,152 --> 00:21:07,273 Have you done this before? I mean, how common is this ECMO? 460 00:21:07,404 --> 00:21:10,325 Charlie, you said you were in if they figured it out. 461 00:21:10,458 --> 00:21:11,986 How common is it? 462 00:21:12,118 --> 00:21:15,172 It's not common for this, and it can be hard to wean off ECMO 463 00:21:15,303 --> 00:21:18,059 after removing something that's compressed your lung for so long, 464 00:21:18,192 --> 00:21:19,385 but her heart is healthy. 465 00:21:19,520 --> 00:21:21,179 I don't anticipate that being a problem. 466 00:21:21,311 --> 00:21:23,701 But it could be a problem. 467 00:21:26,656 --> 00:21:28,247 You almost lost me twice. 468 00:21:29,178 --> 00:21:32,497 If we do nothing, this thing just keeps growing inside me 469 00:21:33,095 --> 00:21:38,471 until it squashes all my organs and I'm definitely gone. 470 00:21:39,367 --> 00:21:40,795 I don't wanna live like that. 471 00:21:42,488 --> 00:21:44,179 Slowly suffocating. 472 00:21:44,910 --> 00:21:48,261 I don't want you to have to watch me live like that. 473 00:21:49,424 --> 00:21:52,411 We asked them to come up with a solution. 474 00:21:54,933 --> 00:21:56,361 I'm taking it. 475 00:21:56,493 --> 00:21:58,452 Okay, Dr. Griffith and Dr. Adams will get you prepped, 476 00:21:58,585 --> 00:22:00,908 and we will see you in the OR, okay? 477 00:22:05,820 --> 00:22:07,179 Is it weird that he's not blinking? 478 00:22:07,314 --> 00:22:09,538 Newborn tear ducts aren't fully developed. 479 00:22:09,670 --> 00:22:11,562 It's so cool that you know all this stuff. 480 00:22:12,657 --> 00:22:15,910 Is it bad if I'm not, like, feeling anything? 481 00:22:16,041 --> 00:22:18,132 You mean you don't feel a bond? 482 00:22:19,428 --> 00:22:21,154 -I'm already a terrible mom. -No. 483 00:22:21,286 --> 00:22:24,805 No, it's completely normal, and you're exhausted, 484 00:22:24,938 --> 00:22:26,332 and your hormones are all over the place. 485 00:22:26,465 --> 00:22:29,617 And to be honest, newborns are kinda just blobs. 486 00:22:29,750 --> 00:22:33,068 In a few weeks, he'll be laughing and smiling, and it just... 487 00:22:33,202 --> 00:22:34,530 it gets so much better. 488 00:22:34,993 --> 00:22:36,521 You're a really good doctor. 489 00:22:37,550 --> 00:22:39,375 Are you taking new patients? 490 00:22:39,508 --> 00:22:41,068 - Well, it's-- - Hey. 491 00:22:41,200 --> 00:22:44,122 -How're my girls? -Hey. Well, we made a new friend-- 492 00:22:44,254 --> 00:22:47,375 -Whoa. Oh, my God. -Oh. Oh. Someone call a rapid response! 493 00:22:47,507 --> 00:22:48,702 Right away, Doctor. 494 00:22:57,265 --> 00:22:58,493 She's still seizing. 495 00:22:59,852 --> 00:23:01,214 Someone give me IM midazolam. 496 00:23:01,779 --> 00:23:04,201 She's seven days postpartum. Check her blood pressure. 497 00:23:04,335 --> 00:23:06,293 It's probably eclampsia. She needs mag now. 498 00:23:06,425 --> 00:23:08,317 Did she have any symptoms before she started seizing? 499 00:23:08,450 --> 00:23:10,740 No, she seemed completely fine. It came out of nowhere. 500 00:23:10,872 --> 00:23:12,101 We'll need to get her up to OB. 501 00:23:12,234 --> 00:23:13,495 Will you go up with her? 502 00:23:13,628 --> 00:23:14,755 Whatever you want. 503 00:23:15,519 --> 00:23:16,648 Call me when you get up there. 504 00:23:21,892 --> 00:23:23,186 Scissors. 505 00:23:24,315 --> 00:23:27,169 - Put two units of blood on standby. - -Lap pad. 506 00:23:29,659 --> 00:23:31,385 All right, I secured the cannula. 507 00:23:31,517 --> 00:23:33,342 Adams, are we ready to remove the clamps? 508 00:23:34,139 --> 00:23:36,529 Yeah, ECMO's ready. 509 00:23:40,247 --> 00:23:42,238 Okay, the dark flow. 510 00:23:42,934 --> 00:23:43,964 We have full flow. 511 00:23:44,096 --> 00:23:45,491 Let's try lowering her down. 512 00:23:52,660 --> 00:23:55,083 - At least that worked. - -We're gonna make all of it work. 513 00:23:55,215 --> 00:23:57,405 Griffith, Adams, you may never see another case like this again, 514 00:23:57,539 --> 00:23:59,032 so keep your eyes on the field. 515 00:23:59,165 --> 00:24:02,418 If you see any signs of hemodynamic instability, speak up. 516 00:24:02,549 --> 00:24:05,836 This is not a race. Our goal is not to finish fast. 517 00:24:05,969 --> 00:24:08,226 It is to keep her safe. 518 00:24:08,358 --> 00:24:09,686 - Understood? - Mm-hmm. 519 00:24:09,818 --> 00:24:10,848 Okay. 520 00:24:11,844 --> 00:24:13,138 Okay, London. 521 00:24:13,270 --> 00:24:14,930 Let's intubate. 522 00:24:19,577 --> 00:24:21,933 It's a hormonally active adrenal mass, 523 00:24:22,066 --> 00:24:24,389 so you need to watch out for sudden hypertension. 524 00:24:24,522 --> 00:24:26,214 -I'm planning to use alpha-blockers. -Good. 525 00:24:26,348 --> 00:24:29,467 Well, I assume you're gonna do this open, given the size? 526 00:24:29,600 --> 00:24:32,587 That's the plan. My colleague will actually do it. 527 00:24:32,720 --> 00:24:35,043 I usually stick to robotic procedures. 528 00:24:35,176 --> 00:24:38,030 Oh. You got something against the old-fashioned way? 529 00:24:38,163 --> 00:24:42,146 No, um... ...I have MS, 530 00:24:42,279 --> 00:24:46,029 so standing for long periods in the OR just isn't an option. 531 00:24:46,162 --> 00:24:48,552 I didn't realize. I'm sorry. 532 00:24:48,685 --> 00:24:49,879 No need to be sorry. 533 00:24:50,012 --> 00:24:52,800 I mean, I was devastated after I got the diagnosis. 534 00:24:53,829 --> 00:24:56,085 I had put in so much work my whole career, 535 00:24:56,219 --> 00:24:59,438 and the thought of no longer being in the OR was soul-crushing... 536 00:25:00,534 --> 00:25:01,861 to say the least. 537 00:25:02,591 --> 00:25:05,247 But that's when I realized it was just my fear talking. 538 00:25:06,308 --> 00:25:10,557 And I looked at my symptoms, muscle pain and leg weakness, and I thought, 539 00:25:11,254 --> 00:25:13,345 "If only there was a way to operate 540 00:25:13,478 --> 00:25:16,830 while sitting down without having to hold a scalpel." 541 00:25:19,153 --> 00:25:20,714 Was it a difficult adjustment? 542 00:25:21,476 --> 00:25:24,530 Adjusting to living with a chronic illness is never easy. 543 00:25:24,663 --> 00:25:28,380 But over time, I just turned MS into a pivot. 544 00:25:29,675 --> 00:25:30,803 Not an ending. 545 00:25:31,766 --> 00:25:34,287 Well, you seem to be managing well. 546 00:25:34,421 --> 00:25:37,840 Oh, well, I have my ups and downs, believe me. 547 00:25:37,972 --> 00:25:41,590 But Catherine Fox is flying me around on her private plane 548 00:25:41,723 --> 00:25:44,278 and paying me more money than I know what to do with. 549 00:25:45,838 --> 00:25:47,531 And I still get to do what I love. 550 00:25:48,261 --> 00:25:50,319 Even if it is in a different way. 551 00:25:52,510 --> 00:25:55,994 Now they're gonna go ahead with Bailey's giant teratoma in OR two. 552 00:25:56,459 --> 00:25:59,081 -Ndugu's gonna have to resect-- -Can we just focus, please? 553 00:25:59,711 --> 00:26:01,305 It's a fake patient. Calm down. 554 00:26:01,437 --> 00:26:03,130 Don't tell me to calm down. 555 00:26:03,263 --> 00:26:04,724 What is wrong with you? 556 00:26:05,487 --> 00:26:08,873 Is it about Simone breaking that dumb pact? 557 00:26:09,005 --> 00:26:11,627 No, and stop asking. I'm fine. 558 00:26:11,759 --> 00:26:13,585 No, you don't seem fine. 559 00:26:13,718 --> 00:26:16,307 Well, it's because you are bothering me. 560 00:26:16,772 --> 00:26:19,029 Well, that can't be it. I always bother you. 561 00:26:19,161 --> 00:26:20,323 I'm just... 562 00:26:22,381 --> 00:26:23,940 I'm just tired. 563 00:26:24,571 --> 00:26:26,197 Every day is the same. 564 00:26:26,330 --> 00:26:30,545 It's the same people and the same rooms and the same conversations, 565 00:26:30,678 --> 00:26:33,167 and I'm just sick of it. 566 00:26:33,300 --> 00:26:35,757 Well, I am sorry we are not good enough for you. 567 00:26:35,889 --> 00:26:37,449 I didn't say that. 568 00:26:37,582 --> 00:26:40,436 Yeah, you don't have to defend yourself. We all know you're aloof. 569 00:26:49,265 --> 00:26:52,152 -You're leaving? -Yeah, I've already done a thrombectomy. 570 00:26:52,285 --> 00:26:53,479 You can have it. 571 00:26:53,944 --> 00:26:58,557 Dr. Prescott, please... 572 00:26:59,918 --> 00:27:01,611 What's happening? Who's the doctor? 573 00:27:01,745 --> 00:27:05,296 -Uh... John Burnett. -An intern? 574 00:27:05,428 --> 00:27:07,254 -Let's get a CT. -They're getting a CT. 575 00:27:07,386 --> 00:27:08,880 No, she has eclampsia. 576 00:27:09,013 --> 00:27:10,905 Tell him she needs magnesium . 577 00:27:11,037 --> 00:27:12,599 -Really? -Tell him. 578 00:27:12,730 --> 00:27:13,925 I... 579 00:27:14,623 --> 00:27:16,879 Excuse me, I've got Jo Wilson on the phone, 580 00:27:17,011 --> 00:27:19,302 and she says it's eclampsia, and you should start her on magnesium. 581 00:27:19,434 --> 00:27:22,720 Her BP is only 143 over 91. It could be an intracranial hemorrhage. 582 00:27:22,853 --> 00:27:25,044 -Put me on speaker. -Um... 583 00:27:26,338 --> 00:27:28,296 Okay. You're on speaker. 584 00:27:28,429 --> 00:27:30,022 I understand your concern, 585 00:27:30,155 --> 00:27:33,441 but postpartum eclampsia doesn't always present with a really high BP. 586 00:27:33,574 --> 00:27:34,934 Neither does a brain bleed. 587 00:27:35,067 --> 00:27:36,959 -Barnett. -It's-- It's Burnett. 588 00:27:37,092 --> 00:27:38,984 Whatever. I may be on leave, 589 00:27:39,117 --> 00:27:41,340 but that doesn't mean that I can't schedule you to work every holiday 590 00:27:41,474 --> 00:27:43,962 and make your life miserable. So trust me when I tell you 591 00:27:44,095 --> 00:27:46,552 to start the mag now. 592 00:27:48,874 --> 00:27:50,269 Start IV magnesium. 593 00:27:56,509 --> 00:27:58,267 Your mom's gonna be okay. 594 00:28:00,291 --> 00:28:01,818 We're gonna have to take part of the lower lobe. 595 00:28:01,951 --> 00:28:03,179 Adams, you wanna staple the lung? 596 00:28:03,312 --> 00:28:04,805 Yep. Stapler. 597 00:28:04,939 --> 00:28:06,631 Bailey, you ready to start resecting the adhered diaphragm? 598 00:28:06,764 --> 00:28:08,291 Hey, ready when you are. 599 00:28:08,424 --> 00:28:10,846 Griffith, what should we be careful to avoid? 600 00:28:10,979 --> 00:28:12,705 Hepatic veins and the retro-hepatic IVC. 601 00:28:12,838 --> 00:28:14,497 Good. Let's get the next stapler ready. 602 00:28:14,630 --> 00:28:18,745 London thought fixing up a summer house was a lot of work. 603 00:28:18,878 --> 00:28:21,898 -It's got nothing on fixing up a torso. -Reload, please. 604 00:28:23,890 --> 00:28:27,641 -Uh, BP is bottoming out. -Damn it. I don't see any bleeding. 605 00:28:27,773 --> 00:28:29,268 Neither do I. The staple line looks clean. 606 00:28:29,432 --> 00:28:31,093 Well, something's got to be causing this. What the hell is it? 607 00:28:31,226 --> 00:28:34,710 - Does the ECMO say anything? - There's a suction event alarm. 608 00:28:35,176 --> 00:28:38,527 Okay. Since we took pressure off the lung, could there be volume shifts? 609 00:28:38,659 --> 00:28:40,154 That's definitely possible. Yeah. 610 00:28:40,287 --> 00:28:42,676 Okay, we need to up her pressors and flood her with fluids. 611 00:28:42,808 --> 00:28:45,795 If we don't get flow back right away, she's done. 612 00:28:51,471 --> 00:28:52,666 Push fluids as hard as you can. 613 00:28:52,799 --> 00:28:53,994 -I am. -BP's still dropping. 614 00:28:54,127 --> 00:28:55,586 She can't take this much longer. 615 00:28:55,720 --> 00:28:57,445 I should've listened to that board. 616 00:28:57,578 --> 00:28:59,239 - If I lose her-- - This is not on you. 617 00:28:59,370 --> 00:29:02,192 Come on, come on, come on. Come on. 618 00:29:02,357 --> 00:29:03,552 BP's coming back up. 619 00:29:05,213 --> 00:29:08,564 - Well, that was close. - Okay, folks. 620 00:29:09,394 --> 00:29:11,054 There's still a lot of tumor left. 621 00:29:12,183 --> 00:29:13,874 Griffith, you're on the liver resection. 622 00:29:14,008 --> 00:29:15,866 Adams, you're on the superior mediastinum. 623 00:29:16,629 --> 00:29:18,488 If that's okay with you? 624 00:29:19,783 --> 00:29:21,509 Do what we say when we say it. 625 00:29:21,641 --> 00:29:22,803 Stapler. 626 00:29:27,814 --> 00:29:29,043 Contrast. 627 00:29:31,432 --> 00:29:34,386 There's the occlusion in the iliac vein. Advance more. 628 00:29:36,013 --> 00:29:37,307 Okay, pin the guide wire 629 00:29:37,440 --> 00:29:39,365 and turn on the thrombectomy catheter, please. 630 00:29:42,020 --> 00:29:43,779 It's a shame Janet isn't awake to see this. 631 00:29:43,912 --> 00:29:45,206 It would really turn her... 632 00:29:46,037 --> 00:29:50,882 into a passionate fan of biological science and anatomy. 633 00:29:51,512 --> 00:29:52,973 Okay, I'm in. Turn it off. 634 00:29:53,106 --> 00:29:55,928 I don't get it. If you have to pretend to be someone else 635 00:29:56,059 --> 00:29:57,320 for your partner to wanna sleep with you, 636 00:29:57,453 --> 00:29:59,246 maybe you shouldn't be together. 637 00:29:59,378 --> 00:30:02,664 I've learned you never know what's going on in another person's relationship. 638 00:30:03,694 --> 00:30:04,756 Ready. 639 00:30:05,419 --> 00:30:06,514 Contrast. 640 00:30:10,231 --> 00:30:13,285 Thrombus is gone. The vein is patent. 641 00:30:13,883 --> 00:30:15,177 Great work. 642 00:30:15,310 --> 00:30:16,338 Now to stent. 643 00:30:19,591 --> 00:30:23,708 Thanks again for the consult. I see why Catherine calls you legendary. 644 00:30:23,840 --> 00:30:26,030 Well, she is prone to exaggeration. 645 00:30:26,163 --> 00:30:28,620 I know, but in your case it's true. 646 00:30:28,753 --> 00:30:31,407 Well, you live up to your reputation as well. 647 00:30:31,540 --> 00:30:34,228 Oh, but not enough to consider my recommendation? 648 00:30:36,818 --> 00:30:40,435 -I'm sorry, I-I shouldn't have said that. -No, it's okay. 649 00:30:41,131 --> 00:30:42,560 Can I ask you about something? 650 00:30:43,689 --> 00:30:45,480 Urosymphyseal fistulas. 651 00:30:47,405 --> 00:30:51,088 They are an extremely rare post-op complication of radical prostatectomy. 652 00:30:51,222 --> 00:30:52,914 But the odds aren't zero. 653 00:30:53,047 --> 00:30:54,242 They're close. 654 00:30:54,972 --> 00:30:55,967 What if it happened? 655 00:30:57,096 --> 00:31:00,450 Chronic pain, which often leads to difficulty walking, 656 00:31:01,112 --> 00:31:05,062 - possibly warranting the use of opioids. 657 00:31:06,157 --> 00:31:08,515 I can treat complications. 658 00:31:09,277 --> 00:31:13,659 But if your cancer grows and metastasizes, that's when my hands are tied. 659 00:31:17,840 --> 00:31:19,134 If you change your mind 660 00:31:19,268 --> 00:31:22,752 or if you just wanna talk more, Catherine has my number. 661 00:31:35,796 --> 00:31:38,253 -Done resecting the liver. -Good. 662 00:31:38,386 --> 00:31:39,712 Excellent hemostasis. 663 00:31:43,562 --> 00:31:45,356 All right, no bleeding on this side. 664 00:31:45,488 --> 00:31:47,281 Okay, we are in the home stretch. 665 00:31:47,414 --> 00:31:49,537 Let's get ready to get this tumor out. 666 00:31:50,565 --> 00:31:52,392 Hold on, hold on. 667 00:31:52,524 --> 00:31:54,714 -Do you hear that? -What? 668 00:31:57,602 --> 00:31:59,329 Okay, we're gonna need more lap pads, and hang blood. 669 00:31:59,462 --> 00:32:01,188 Adams, quickly pack her. 670 00:32:01,950 --> 00:32:04,108 Goddamn it! All right, keep the suction coming. 671 00:32:05,170 --> 00:32:06,696 Oh... ... wait, wait. 672 00:32:06,829 --> 00:32:10,381 Okay, there's a tear where the IVC passes 673 00:32:10,513 --> 00:32:12,206 through the diaphragm into the chest. 674 00:32:12,339 --> 00:32:15,260 I'm trying to secure... Let-Let me have a clamp. 675 00:32:15,723 --> 00:32:17,085 Okay, I need visualization. 676 00:32:17,218 --> 00:32:18,445 Put the suction on the lap pads. 677 00:32:18,578 --> 00:32:21,068 Not too harsh, gentle steady pressure, okay? 678 00:32:26,943 --> 00:32:28,369 I think I got it. 679 00:32:31,522 --> 00:32:34,212 Oh, she's stabilizing. 680 00:32:34,343 --> 00:32:36,368 Okay, everyone, on the count of three. 681 00:32:36,501 --> 00:32:38,062 Everyone needs to help with the specimen. 682 00:32:38,195 --> 00:32:39,355 Okay, ready? 683 00:32:39,488 --> 00:32:42,277 One, two, three. 684 00:32:47,553 --> 00:32:48,582 Okay. 685 00:32:55,021 --> 00:32:56,150 Okay. 686 00:32:56,614 --> 00:32:58,506 How do you all feel about getting the hell out of here? 687 00:32:58,638 --> 00:33:00,831 You don't have to ask me twice. Bovie. 688 00:33:01,692 --> 00:33:03,385 Two-O prolene. 689 00:33:10,157 --> 00:33:11,217 You can stop here. 690 00:33:11,849 --> 00:33:12,944 Iris. 691 00:33:13,608 --> 00:33:15,136 Hey, what are you doing up here? 692 00:33:15,267 --> 00:33:18,487 So a mom from the NICU is being treated for postpartum eclampsia. 693 00:33:18,619 --> 00:33:21,174 Can you look up her chart? Her name is Gina... 694 00:33:21,906 --> 00:33:23,002 I don't know her last name. 695 00:33:23,565 --> 00:33:25,789 I'm sorry, I can't. You're not her doctor. 696 00:33:27,084 --> 00:33:28,377 I just wanna check on her. 697 00:33:29,340 --> 00:33:31,464 Do you want me to call Marcus for you? 698 00:33:31,598 --> 00:33:33,455 No, what I want is my friend's chart. 699 00:33:34,618 --> 00:33:36,144 -I'm sorry, Jo. -Stop saying you're sorry. 700 00:33:36,276 --> 00:33:38,601 Sorry doesn't help me. I'm this woman's only friend right now 701 00:33:38,733 --> 00:33:39,962 and the person in charge of her care 702 00:33:40,093 --> 00:33:41,555 has been a doctor for about 90 days. 703 00:33:41,687 --> 00:33:43,646 So, if you could just please remove the stick from-- 704 00:33:43,778 --> 00:33:45,637 -Jo. -All I want right now-- 705 00:33:45,770 --> 00:33:47,562 - I think we should go. - -No, we're not gonna go. 706 00:33:47,694 --> 00:33:48,657 -I-- No. -Yeah. 707 00:33:48,790 --> 00:33:51,246 You cannot move me against my will. 708 00:33:51,378 --> 00:33:53,536 Stop. I... 709 00:33:54,166 --> 00:33:55,860 This is not okay. 710 00:33:55,991 --> 00:33:57,286 Can you give me a minute? 711 00:33:57,419 --> 00:33:58,781 -This is-- -Hey, hey, hey, hey. 712 00:33:58,913 --> 00:34:01,169 Look, I know you're scared, okay? But... 713 00:34:02,498 --> 00:34:04,255 Hey, she's just trying to do her job. 714 00:34:22,544 --> 00:34:26,062 It will take a few days to wean her off ECMO. She does have a long recovery. 715 00:34:26,195 --> 00:34:28,353 - But she's gonna come home? - Eventually. 716 00:34:28,486 --> 00:34:30,111 That is the plan. 717 00:34:30,743 --> 00:34:32,169 I don't know how to thank you. 718 00:34:32,801 --> 00:34:34,160 I think you just did. 719 00:34:36,848 --> 00:34:39,438 She's always been able to see what I can't. 720 00:34:39,969 --> 00:34:43,088 Her mind is filled with these big ideas 721 00:34:43,222 --> 00:34:45,745 that always seem impossible. 722 00:34:45,876 --> 00:34:51,021 Our wedding, this lake house, getting this tumor removed. 723 00:34:52,582 --> 00:34:54,107 But she knew you could do it. 724 00:34:56,167 --> 00:34:57,693 And she was right. 725 00:34:58,853 --> 00:35:01,676 I almost... ...tried to stop her. 726 00:35:04,132 --> 00:35:06,056 But I'm glad I stayed out of it. 727 00:35:07,451 --> 00:35:10,139 Hey, um, we'll let you both get some rest. 728 00:35:10,769 --> 00:35:12,727 Thank you. 729 00:35:15,450 --> 00:35:17,176 Great work today, Griffith. 730 00:35:17,308 --> 00:35:19,963 You and Adams, you really stepped it up. 731 00:35:20,096 --> 00:35:23,879 Thank you. I really appreciate the opportunity. I learned a lot. 732 00:35:27,498 --> 00:35:32,543 We did a good thing today. 733 00:35:32,674 --> 00:35:35,995 -Some might call it inspiring. -Mmm. 734 00:35:36,127 --> 00:35:37,620 Might be even something 735 00:35:37,752 --> 00:35:40,010 you could lecture about. 736 00:35:40,144 --> 00:35:43,660 Hey, I hope I didn't overstep, you know, jumping in with the residents. 737 00:35:43,793 --> 00:35:46,914 Oh, no. I mean, if I'm the only voice that's teaching them, 738 00:35:47,047 --> 00:35:48,639 they'll wind up tuning me out. 739 00:35:49,502 --> 00:35:50,997 What do you think about having the residents 740 00:35:51,129 --> 00:35:53,485 do an ambulance ride-along or EMS training? 741 00:35:53,617 --> 00:35:56,406 Something that could really get them thinking on their feet, you know? 742 00:35:56,539 --> 00:36:01,119 It could help them in the ER or in situations like today in the OR. 743 00:36:01,716 --> 00:36:05,899 I think you should write up a proposal and send it to me. 744 00:36:09,615 --> 00:36:10,977 The surgery went well. 745 00:36:11,110 --> 00:36:13,102 We were able to clear the clot and put in a stent. 746 00:36:13,234 --> 00:36:14,230 Thank you. 747 00:36:14,363 --> 00:36:15,923 You'll need to be on anticoagulation 748 00:36:16,055 --> 00:36:19,473 but after a while, you'll be able to get back to life as usual. 749 00:36:20,171 --> 00:36:23,622 I'll get back to life as usual right away or... 750 00:36:23,755 --> 00:36:25,216 "When can I have sex?" is what I'm asking. 751 00:36:25,347 --> 00:36:26,809 Yeah, we know. 752 00:36:26,942 --> 00:36:28,367 You need to elevate your leg when resting 753 00:36:28,501 --> 00:36:31,421 but other than that, it is good to move it around. 754 00:36:33,215 --> 00:36:35,073 I guess Trudy can still see the doctor. 755 00:36:35,206 --> 00:36:37,761 Trudy's always a good time. 756 00:36:37,895 --> 00:36:42,010 But, honey, I love you most when you're just Janet. 757 00:36:43,968 --> 00:36:45,163 Oh. 758 00:36:45,294 --> 00:36:46,723 We'll give you some privacy. 759 00:36:58,439 --> 00:37:00,329 I checked London's labs before leaving. 760 00:37:01,292 --> 00:37:02,221 Thanks. 761 00:37:02,355 --> 00:37:04,148 Hey, I'm sorry about earlier. 762 00:37:04,679 --> 00:37:06,704 How you interact with your patients, your business. 763 00:37:06,836 --> 00:37:07,931 I'll stay out of it. 764 00:37:08,064 --> 00:37:09,624 I appreciate that. 765 00:37:10,686 --> 00:37:13,441 I do value your opinion though. 766 00:37:14,006 --> 00:37:15,598 -You do? -I do. 767 00:37:15,732 --> 00:37:21,440 Just, uh, not about relationships. For obvious reasons. 768 00:37:21,573 --> 00:37:23,797 Ouch. 769 00:37:23,929 --> 00:37:26,684 Hey, look, I'm, uh, putting together a watch list for my patient. 770 00:37:27,181 --> 00:37:28,344 What am I missing? 771 00:37:28,476 --> 00:37:30,601 Mmm. 772 00:37:32,126 --> 00:37:35,480 - Wait, she hasn't seen any of these? 773 00:37:42,881 --> 00:37:44,207 Hey. 774 00:37:44,707 --> 00:37:45,802 Hi. 775 00:37:45,934 --> 00:37:47,627 Did you make it through your busy day? 776 00:37:47,759 --> 00:37:49,785 Uh, I did. 777 00:37:50,847 --> 00:37:53,435 Uh, I did a thrombectomy and placed a stent. 778 00:37:53,568 --> 00:37:55,626 Nice, Millin. 779 00:37:55,759 --> 00:37:57,916 You still haven't told me about that thoracotomy, by the way. 780 00:37:59,043 --> 00:38:00,206 It wasn't that big a deal. 781 00:38:00,837 --> 00:38:03,160 Uh, you saved a man's life with your hands. 782 00:38:03,724 --> 00:38:05,251 Doesn't get any bigger than that. 783 00:38:08,038 --> 00:38:09,533 Do you think I'm aloof? 784 00:38:10,528 --> 00:38:14,444 Aloof? Thank you. Um... 785 00:38:15,007 --> 00:38:16,071 No. 786 00:38:16,535 --> 00:38:19,191 No, you're discerning, you don't suffer any fools. 787 00:38:19,324 --> 00:38:22,045 But... ...that's not aloof. 788 00:38:22,178 --> 00:38:26,127 That's, um, just protecting yourself because you care. 789 00:38:29,148 --> 00:38:32,434 It's funny you say that because I-I have been... 790 00:38:32,897 --> 00:38:35,421 I had the worst day. 791 00:38:35,553 --> 00:38:37,976 I need the biggest vodka tonic that they have. 792 00:38:38,740 --> 00:38:40,532 Hi, I'm Iris. 793 00:38:40,665 --> 00:38:42,523 Uh, this is Jules Millin, a surgical resident. 794 00:38:43,022 --> 00:38:44,482 -Nice to meet you. -Nice to meet you. 795 00:38:44,615 --> 00:38:47,635 Um, I should go find my friends. 796 00:38:49,229 --> 00:38:50,689 -Here. -Thank you. 797 00:38:50,820 --> 00:38:52,082 See you later. 798 00:38:52,216 --> 00:38:54,672 It's jarring when your identity shifts. 799 00:38:54,803 --> 00:38:58,190 When you're suddenly a doctor, a partner, a parent. 800 00:38:59,085 --> 00:39:01,673 It helps if you focus on the things that haven't changed. 801 00:39:01,806 --> 00:39:03,534 I'm gonna have to change hospitals. 802 00:39:04,429 --> 00:39:06,652 I've cried in front of too many people at this one. 803 00:39:06,784 --> 00:39:08,014 They understand. 804 00:39:10,767 --> 00:39:15,050 I just feel like ever since I was admitted, I just... 805 00:39:15,646 --> 00:39:17,605 I just lost myself. 806 00:39:19,398 --> 00:39:21,124 I can't take care of our kids. 807 00:39:21,256 --> 00:39:25,239 I can't take care of my patients. I can't even shower. 808 00:39:25,372 --> 00:39:26,666 It's temporary. 809 00:39:27,364 --> 00:39:28,757 Your heart is recovering. 810 00:39:28,891 --> 00:39:30,152 I know. 811 00:39:31,213 --> 00:39:37,388 But for a few hours today, I got to be a doctor again 812 00:39:37,519 --> 00:39:39,710 and help this woman navigate a difficult time 813 00:39:39,844 --> 00:39:46,116 but then when it really mattered, someone else got to help her. 814 00:39:47,676 --> 00:39:49,170 At least Gina is okay. 815 00:39:50,000 --> 00:39:54,082 And I would bet that she'd say what you did mattered too. 816 00:39:55,775 --> 00:39:57,136 Maybe even more. 817 00:39:59,293 --> 00:40:01,085 Oh, God. It's happening again. 818 00:40:01,881 --> 00:40:05,333 - No. - I'll get the tissues. 819 00:40:07,823 --> 00:40:12,037 Just... 820 00:40:12,702 --> 00:40:14,229 The comfort of old friends. 821 00:40:14,360 --> 00:40:17,149 Thirty-five pounds? That's like carrying four babies. 822 00:40:17,281 --> 00:40:19,041 Yeah, or four bowling balls. 823 00:40:19,173 --> 00:40:21,862 -Who carries four bowling balls? -People do weird things. 824 00:40:23,655 --> 00:40:24,816 Gotta go. 825 00:40:29,396 --> 00:40:30,856 Yeah, I'm out too. 826 00:40:31,919 --> 00:40:33,081 See you tomorrow. 827 00:40:41,113 --> 00:40:43,768 She's just a stop sign, not a roadblock. 828 00:40:43,900 --> 00:40:44,863 How did you... 829 00:40:46,821 --> 00:40:50,074 Doesn't matter. Wait, are you leaving me too? 830 00:40:50,671 --> 00:40:53,824 Um, sorry. Um, hey, have a drink on me. 831 00:40:59,600 --> 00:41:00,628 Anyone sitting here? 832 00:41:06,071 --> 00:41:07,665 The thrill of trying something new. 833 00:41:07,797 --> 00:41:09,291 Hi, I'm Sally. 834 00:41:09,423 --> 00:41:11,647 Because even though you may not recognize yourself. 835 00:41:12,244 --> 00:41:13,307 Catherine. 836 00:41:14,236 --> 00:41:17,024 I'm sorry. I am so sorry. 837 00:41:17,157 --> 00:41:20,111 I got scared and I just called the best that I knew. 838 00:41:20,244 --> 00:41:22,102 I should've talked to you before bringing Laura in. 839 00:41:22,235 --> 00:41:27,678 Look, I thought a lot about letting fear cloud judgment today. 840 00:41:27,811 --> 00:41:30,234 Whatever you wanna do, I support-- 841 00:41:31,529 --> 00:41:32,823 I'm a surgeon. 842 00:41:32,955 --> 00:41:35,013 I'm a senior member of this hospital. 843 00:41:36,009 --> 00:41:37,403 If something were to go wrong 844 00:41:37,536 --> 00:41:40,789 and I couldn't stand long enough to do a simple appy, 845 00:41:40,921 --> 00:41:43,908 I'd feel weak. 846 00:41:44,938 --> 00:41:46,597 And I don't know how to lead like that. 847 00:41:47,128 --> 00:41:48,621 I don't know who I'd be. 848 00:41:49,617 --> 00:41:50,977 But people adapt. 849 00:41:51,808 --> 00:41:53,500 I wanna go ahead with the surgery. 850 00:42:00,238 --> 00:42:02,096 It's been you all along. 66547

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